Incidental Interaction: Novel Technology to Support Elders-as-Athletes through Augmenting Everyday Interactions
Lead Research Organisation:
University of Southampton
Department Name: Sch of Electronics and Computer Sci
Abstract
Elders classically are framed as people who are inevitably getting weaker, losing muscle and bone mass, cognitive capacity, and inevitably requiring care to manage simple "activities of daily living" such as walking, feeding, toileting and bathing. These effects limit their capacity to live independently and healthily in their own homes.
To address this decline, research in even just the past five years has been looking for new molecules and therapies to slow or reverse aging, to provide if not longer life, then better quality of life throughout the life course. While these advances in science and technology promise wonders (for those who will be able to afford them), there is already established science that demonstrates how we can all improve our life quality over our lifespan. This same science can, today, improve the life quality of our elders - starting these interventions at any age. It's building strength:a well understood, human practice. No technology is required to build and maintain strength; only to move against gravity. Repeatedly. Research has repeatedly shown that resistance training for elders can improve quality of life while mitigating if not eliminating age associated co-morbidities.
And yet, for all its proven effective, cheap - even free - benefits for healthful longevity, many elders are simply too weak to take care of themselves. According to a 2019 report from AgeUk on the State of Elder health, 15% of those aged 65-69, rising to 1 in 3 citizens over 85 in the UK require care.
Some of the well-documented challenges to strength building are that, unlike a pill or garment or augmentation, to achieve the benefits of strength, one has to do the work oneself, actively. That takes time, effort, as well as the knowledge, skills and practices to support it. Mustering the effort can be even harder to achieve when one is already feeling weak, recuperating from an injury, a hospital stay, or from loneliness of isolation.
The research in this project is specifically designed to address the challenges that keep elders from actively engaging in strength work. Our approach is to co-create interactions to help build the knowledge skills and opportunities to practice to build and preserve the strength needed to maintain healthful independence at home. Our approach is simple: design interactive technology and gestures to leverage what we - including elders - do every day that is already strength work: stand, sit, grip, pull, push, reach, balance - and translate these into activities for building strength. We call it this novel protocol "do it twice." Stand from sitting? That's strength. Do it twice. That's strength building - and that supports the knowledge skills and practice of "elder athletes" building capabilities rather than requiring assistance.
Our approach is interdisciplinary: experts in Human Computer Interaction, Sensors and Physiotherapy, developing novel, affordable interactive technologies to make strength practice accessible effective and enjoyable with support to guide these activities, reflect progress, and share with friends. We call the approach "incidental interaction for everyday strength."
So far, we have tested the approach for feasibility. In this small project, with our partners in sustainable, assisted living housing, NHS Trusts, professional therapy and coaching, and with participating elders as co-designers, we will be refining the interaction, the sensors and the exercise protocols. We will be able to tune our work at each stage to ensure best engagement. In three phases from design, to testing, to in-home evaluations we will together be validating the accessibility and efficacy of our approach.
By realizing with this project the potential our preliminary work indicates and that our partners anticipate, we will contribute a new affordable breakthrough approach to help transform elder health and care, to enable longer, stronger elder independence@home.
To address this decline, research in even just the past five years has been looking for new molecules and therapies to slow or reverse aging, to provide if not longer life, then better quality of life throughout the life course. While these advances in science and technology promise wonders (for those who will be able to afford them), there is already established science that demonstrates how we can all improve our life quality over our lifespan. This same science can, today, improve the life quality of our elders - starting these interventions at any age. It's building strength:a well understood, human practice. No technology is required to build and maintain strength; only to move against gravity. Repeatedly. Research has repeatedly shown that resistance training for elders can improve quality of life while mitigating if not eliminating age associated co-morbidities.
And yet, for all its proven effective, cheap - even free - benefits for healthful longevity, many elders are simply too weak to take care of themselves. According to a 2019 report from AgeUk on the State of Elder health, 15% of those aged 65-69, rising to 1 in 3 citizens over 85 in the UK require care.
Some of the well-documented challenges to strength building are that, unlike a pill or garment or augmentation, to achieve the benefits of strength, one has to do the work oneself, actively. That takes time, effort, as well as the knowledge, skills and practices to support it. Mustering the effort can be even harder to achieve when one is already feeling weak, recuperating from an injury, a hospital stay, or from loneliness of isolation.
The research in this project is specifically designed to address the challenges that keep elders from actively engaging in strength work. Our approach is to co-create interactions to help build the knowledge skills and opportunities to practice to build and preserve the strength needed to maintain healthful independence at home. Our approach is simple: design interactive technology and gestures to leverage what we - including elders - do every day that is already strength work: stand, sit, grip, pull, push, reach, balance - and translate these into activities for building strength. We call it this novel protocol "do it twice." Stand from sitting? That's strength. Do it twice. That's strength building - and that supports the knowledge skills and practice of "elder athletes" building capabilities rather than requiring assistance.
Our approach is interdisciplinary: experts in Human Computer Interaction, Sensors and Physiotherapy, developing novel, affordable interactive technologies to make strength practice accessible effective and enjoyable with support to guide these activities, reflect progress, and share with friends. We call the approach "incidental interaction for everyday strength."
So far, we have tested the approach for feasibility. In this small project, with our partners in sustainable, assisted living housing, NHS Trusts, professional therapy and coaching, and with participating elders as co-designers, we will be refining the interaction, the sensors and the exercise protocols. We will be able to tune our work at each stage to ensure best engagement. In three phases from design, to testing, to in-home evaluations we will together be validating the accessibility and efficacy of our approach.
By realizing with this project the potential our preliminary work indicates and that our partners anticipate, we will contribute a new affordable breakthrough approach to help transform elder health and care, to enable longer, stronger elder independence@home.
| Description | Outcome: initial system PPIE work - over summer 2024, we evaluated the prototype with PPIE participation for feedback on the interaction approach with the system. On the basis of these meetings we refined the prototype. As noted in Engagement, we took the prototoype on the road for further feedback at community events. Outcome: System in use. We have just completed a two week in-home-use phase with participants to explore how the system can work in diverse settings. We also offered participants pre/post assessments of their own strength and balance within this brief time frame. We are just now incorporating the feedback from this work towards an upcoming 6week, in home deployment to test real efficacy on strength and balance, as well as persistence of engagement with the kit. What we are learning from this preliminary testing is that as d.rose of MIT postulated a decade ago, delightful objects can support engagement. Despite the fact that our work is meant to support already in practice daily activities, to help formulate them as strength work, the way the elements are designed to remind folks of opportunities to move, or to move the objects, they are engaging with the objects like our new Can Band - to elicit the object's response. We have also been engaging with social workers via Hampshire Council to offer the interaction approach, and to share the physiology and metabolics underpinning the "do it twice" approach. This is also leading to a series of workshops to build on these foundations to build new tools and knowledge for carers to work with their people, and the associated families to build shared experiences of health to support health. We'd also note that as a systems project there are delays while building and testing prior to publishable outcomes - these are in progress now, and will be wrapped up post our next, in the wild evaluation of the system. |
| Exploitation Route | Several avenues are opening up: 1) IP related - our IP team is encouraging us to carry out larger trials towards building an evidence base for industry engagement in scaling up and out the Incidental Interaction/do it twice approach - which is both hardware/software and protocol. 2) We are applying for funding towards building up just such research evaluations 3) we are also developing a program grant that can explore the broader and deeper lifecycle of such healthfulness support. |
| Sectors | Digital/Communication/Information Technologies (including Software) Healthcare Other |
| Description | Stemming from an initial engagement with Hampshire Council to seek their participation in a survey of older adults around perceptions of exercise and of interactive technologies, we have been building a series of workshops around knowledge sharing around the hows and why's of movement beyond strength and balance to include cognitive function, better sleep, reduced falls and so on. We are now combining work from both the HRIT fellowship - particularly the XB app to explore Move Eat Sleep practices - among the social workers - as a foundation towards designing how to help family and the individuals receiving their support - better support their own health - including recovery. |
| First Year Of Impact | 2024 |
| Sector | Digital/Communication/Information Technologies (including Software),Healthcare,Government, Democracy and Justice |
| Impact Types | Societal Policy & public services |
| Title | Outreach Survey in Partnership with Hampshire County Council |
| Description | Outreach survey collecting qualitative and quantative information on elders daily activities, modes of transportation, relationship with exercise, and relationship with technology. 40+ respondents from the UK |
| Type Of Material | Database/Collection of data |
| Year Produced | 2024 |
| Provided To Others? | No |
| Impact | The data from this survey has informed design decisions for the technology by helping to better understand the daily routines, exercise preferences, and technology experiences of elders with which our system is meant to service. We also plan to submit a manuscript based on the outreach survey to help inform others in the field on the nuances of designing fitness technologies aimed as supporting elders. |
| Title | Strength Building System Through Incidental Tasks (Can Band). |
| Description | The system integrates various sensors, including a pressure-sensitive sensor, a light sensor, and an IMU sensor, all embedded in a device the size of a water bottle or a can, hence the name "can-band." The light sensor toggles between active and sleep modes. When the can-band is placed inside a kitchen cabinet, it enters sleep mode. Upon opening the cabinet, the light sensor activates an LED panel, reminding the user to move the can-band device. The IMU sensor tracks the direction of movement, and once the user places the device down again, the panel displays an arrow suggesting they move it back the other way. Alongside this, the pressure-sensitive sensor measures the grip force applied by the user. These sensors are configured using an ESP-32 micro controller, which communicates with a Raspberry Pi serving as the central hub. The Raspberry Pi displays, in real time, the back-and-forth movements, grip strength levels performed by the user. |
| Type Of Technology | Physical Model/Kit |
| Year Produced | 2025 |
| Impact | The system is currently being tested in potential users' homes. Participants aged 65 and older will use the system in trial periods of two and six weeks. Overall output values and user feedback will be collected at the end of these trials. |
| Title | Strength Building System Through Incidental Tasks (Smart Chair). |
| Description | The system integrates pressure sensitive sensors that blend seamlessly with ordinary furniture. These sensors are strategically placed around a standard chair: one beneath the cushion, one as a floor mat in front of the chair, and two on each armrest. Each sensor is configured with an ESP-32 micro controller. Together, the sensors communicate with a Raspberry Pi, which functions as a central hub, continuously tracking incidental activity throughout the day. The system particularly detects when the user sits, stands, and if either armrest is leaned on for support. A tablet-sized monitor displays the daily count of "double sit-stands," helping users track their progress over time and stay motivated to improve. All interaction data is tracked and stored in real time, including the duration it takes for the user to complete a double sit-stand. Users can review a weekly summary and provide feedback on their daily experience with the system, fostering continuous engagement and improvement. |
| Type Of Technology | Physical Model/Kit |
| Year Produced | 2025 |
| Impact | The system is currently being tested in potential users' homes. Participants aged 65 and older will use the system in trial periods of two and six weeks. Health measures, including leg strength and surveys on physical activity and health-related quality of life, will be assessed at the end of the trials. |
| Description | Activity Perceptions of Elder Athletes |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Public/other audiences |
| Results and Impact | The activity is a survey, post in person presentation, of how participants perceive activity, technologies that support physical activity, and any technologies that support physical activity - Our goal in these conversations is to have a good basis for informing our interaction approach in this project - to speak the same language as our community of users, and to invite interest and participation in the process. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Co-design workshop |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Study participants or study members |
| Results and Impact | Participants from a range of ages met with us to pilot test our proposed interaction with our system to offer insights and feedback on our approach. |
| Year(s) Of Engagement Activity | 2023 |
| Description | Do it Twice - Incidental Interaction - A novel protocol to support more movement doing what you're already doing |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Professional Practitioners |
| Results and Impact | This is an invited presentation to share our new approach for engaging with elders in particular to build health - and how our associated work on explorations/experiments informed the approach. We are keen on feedback from pros on how they see the work could be applied for their communities. Their interest in further engagement towards supporting participation and co-design will lead to further collaboration such as workshops and co-design activities to help make this kind of approach work for them and their jobs, too. |
| Year(s) Of Engagement Activity | 2023 |
| URL | https://www.wellthlab.ac.uk/projects/elderathlete/ |
| Description | EPSRC Healthcare Technologies Visit |
| Form Of Engagement Activity | Participation in an open day or visit at my research institution |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Supporters |
| Results and Impact | Demo event set up at the University of Southampton for the EPSRC health technology team. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Engagement demo at local community cafe (Abri) |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Study participants or study members |
| Results and Impact | The purpose of this visit was to run an engagement event at a local community cafe, demonstrating our system and allowing visitors to try it out. We used this event to gather feedback about the system from potential users. We also had signup sheets where individuals could register their interest in further research, and be contacted for participation in the future. Around 25 individuals attended during the four-hour session, with three individuals singing up for updates/participation. Two were industry contacts who were keen to connect us with further potential users, one was a potential participant. This participant has since taken part in our initial feasibility testing - a two week at home deployment. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Engagement demo with local residents association (Highfield Residents Association) |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Study participants or study members |
| Results and Impact | This was a two hour engagement activity with a local residents association. During the session, those visiting had the opportunity to provide feedback and sign up for updates and participation opportunities. In total, around 25 individuals visited the demo. We gathered feedback on the system, which provided opportunities for further development. Five individuals signed up for future updates. One of these was an individual hoping to link us with connections in the future, and four were interested in future participation. Since the event, one of these individuals has taken part in initial feasibility testing - a two-week at home deployment. |
| Year(s) Of Engagement Activity | 2024 |
| Description | National Institute on Aging (NIA) USA workshop Leveraging Adaptive Technology ("Just-In-Time") Interventions for Aging and AD/ADRD |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Policymakers/politicians |
| Results and Impact | A 2017 NASEM workshop, "Preventing Cognitive Decline and Dementia", suggested numerous ways to construct a stronger evidence base for the prevention of cognitive decline and AD/ADRD, including encouraging, but inconclusive evidence for cognitive training, blood pressure management, and physical activity interventions. This was followed by several meetings convened by the NIA, which emphasized the need for non-pharmacological approaches to address risks factors for healthy aging and AD/ADRD. Just-In-Time Adaptive Interventions are an exciting approach that can be implemented through a combination of mobile and sensor technologies to monitor the state and context of an individual and provide the appropriate amount and type of intervention at the right time. The workshop aimed to explore various topics related to the development and deployment of digital health-based adaptive interventions targeting positive behavior change in one or more daily behaviors to reduce risks for health aging and AD/ADRD. Approx 100+ people attended. A core outcome was a special report for NIH on the approach, including EPSRC funded work from our HRIT fellowshop and Elder Athlete/Incidental Interaction Project - towards funding for future work in this approach. Additionally, new collaborations have formed among the participants with anticipated actions to take place in 2025 and beyond. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://www.nia.nih.gov/research/dbsr-dgcg-dn/workshops/leveraging-adaptive-technology-just-time-int... |
| Description | You are Not a Plant - Move as essential for Humans |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Professional Practitioners |
| Results and Impact | 2nd Invited Seminar for social workers of Hampshire Council - how to explore the role of movement for elders (and carers and family) as an essential part of life and health. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://www.wellthlab.ac.uk/notplants/ |
